Osteopathic Manipulation Treatment (OMT)

What is osteopathic manipulative treatment (OMT)?

Osteopathic manipulative treatment (OMT) is a hands-on approach for easing musculoskeletal pain and other health conditions. Doctors of osteopathic medicine, called DOs or osteopaths, most frequently perform the treatment, but medical doctors (MDs) with specialty training can also perform it. OMT also goes by osteopathic manipulation treatment.

Doctors use OMT to treat mechanical pain (muscle, fascia, connective tissue, joint or bone pain due to structural imbalance). They also use OMT to diagnose and prevent disease and help your body function better.

Using several OMT techniques, doctors apply gentle pressure to manipulate your muscles, soft tissues and joints. Doctors can also do “popping” or thrust-based techniques but those are used generally less often than with a chiropractor. Your doctor will discuss the recommended technique before it’s used to make sure you’re comfortable. The osteopathic manipulative treatment encourages your body to heal itself by ensuring that your bones and muscles are aligned and balanced properly.

What are doctors of osteopathic medicine?

Doctors of osteopathic medicine (DOs) are fully licensed physicians. They practice in all specialties just like medical doctors (MDs). There are different medical schools for DOs and MDs, but the years of schooling and medical specialties are the same.

• Doctors of medicine (MDs) practice allopathic medicine. Allopathy focuses on treating illnesses or symptoms with conventional therapies like medications and surgeries.
• Doctors of osteopathic medicine (DOs) practice osteopathic medicine. Osteopathy is a holistic approach to care. DOs treat the whole person — mind, body and spirit — not just a disease or symptoms.

A doctor of osteopathy practices osteopathic manipulative medicine (OMM), a type of medicine that includes hands-on treatments. DOs have special training in healing your body, most commonly your musculoskeletal system, but they’re licensed to treat the full range of health conditions.

Who needs osteopathic manipulative treatment (OMT)?

Most people get OMT to treat lower back pain, neck pain or migraines, but doctors use OMT to treat many different conditions. Babies, children and adults can benefit from osteopathic manipulative treatment. Pregnant people get OMT to improve sleep and relieve pain. OMT may also possibly help infants who have colic, difficulty breastfeeding or have recurrent ear infections.

People who have undiagnosed pain will receive a consultation prior to osteopathic manipulation to see if the treatment is right for them.

What does OMT treat?

Doctors usually use osteopathic manipulative treatment for back, neck and head pain relief. But OMT can treat many conditions, including:

• Breathing issues, like asthma and sinus infections
• Bowel issues, like irritable bowel syndrome (IBS) and constipation
• Chronic pain, including fibromyalgia and arthritis
• Musculoskeletal problems, like joint pain and carpal tunnel syndrome
• Problems associated with pregnancy, like swelling (edema), insomnia and sciatica
• Gynecological issues, like chronic pelvic pain and tailbone pain (coccydynia)
• Sports injuries and repetitive stress injuries

By helping restore your structural balance, OMT improves nerve and blood circulation to the bodily organ involved — which can help improve the health of that organ.

What happens before osteopathic manipulation treatment (OMT)?

Your healthcare provider will ask about your symptoms, lifestyle and other health concerns. It’s important to share information about your sleep habits, activity level, diet and mental health. Providers use this information to gain a clear picture of how your lifestyle affects your overall well-being.

Your provider will examine you by touching or pressing on different parts of your body. Depending on your symptoms, your provider may order imaging studies (like an X-ray or MRI) before starting OMT.

What happens during OMT?

During osteopathic manipulation, you’ll stand up, sit or lie down on an exam table. Your healthcare provider will touch your muscles and soft tissues and move your limbs in different positions. There are many different techniques. Your provider may use one technique or several of them.

Depending on the technique, your provider may ask you to lay on your back, roll onto your side or pull your knees to your chest. While you’re in these positions, your provider will use pressure and gentle manipulation to stretch your muscles and move your joints into proper alignment. Your provider may ask you to hold and release your breath at specific times.

Your provider may use slow, continuous pressure or quick, sudden manipulations. Some of the movements may feel a little strange or awkward, but they shouldn’t cause severe pain. If you feel pain or discomfort during treatment, tell your provider right away.

What are the types of OMT techniques?

There are many different OMT techniques. The type of OMT you receive depends on your symptoms, condition and the affected body system.

OMT techniques include but aren’t limited to:

• Balanced ligamentous tension. Pressing lightly on a joint to get it into the proper place and improve range of motion.
• Cranial osteopathy. Applying gentle pressure to your head and spine to ease tension. This technique helps with head and neck pain, as well as issues like temporomandibular joint (TMJ) disorders.
• Diaphragm techniques. Applying soft pressure to your diaphragm to move tissues, which improves breathing and eases back pain.
• Lymphatic pump. Performing pumping or pulse-like actions to your feet, chest or abdomen to clear lymphatic system blockages. This treatment can also reduce swelling (edema) and ease symptoms of digestive system and respiratory system infections.
• Muscle energy. Relaxing and lengthening muscles to increase range of motion, ease pain and improve circulation.
• Myofascial release. Relaxing tight myofascial (muscle and fascia) tissue to promote blood flow and ease pain.
• Rib raising. Gentle lifting of your ribs to stretch the fascia and open your ribcage, allowing your lungs to expand and improve breathing.

What happens after OMT?

Everyone responds to osteopathic manipulation differently. You may feel sore for a day or two after treatment. Some people feel tired after OMT. Others feel energized.

After each treatment session, you should:

• Drink plenty of water. Staying hydrated allows toxins to flush out of your muscles after treatment.
• Go for a walk. A short walk helps your body “settle in” or adjust to the proper alignment and balance.
• Take it easy. Avoid rigorous physical activity for 24 hours after OMT. Focus on breathing and allowing your body time to rest.

What are the advantages of osteopathic manipulation treatment (OMT)?

Osteopathic manipulative treatment treats conditions that affect every system in your body, including your musculoskeletal system, digestive system, nervous system and immune system. By realigning your body and restoring balance to bones and muscles, OMT allows your entire body to work better as a whole.

Using OMT, your doctor can:

• Address structural problems in your joints, muscles and tissues
• Improve circulation (how blood and other fluids flow through your body)
• Prevent health problems and help your body heal itself by improving how your body works as a unit
• Soothe tight muscles, relieve joint stiffness and improve range of motion

What are the risks or complications of OMT?

OMT techniques are safe. Infrequently, minor soreness and sometimes small bruising can result from certain techniques. Severe pain isn’t a normal side effect of OMT. You and your provider can decide which techniques are right for you and your body. 

When can I go back to my usual activities after osteopathic manipulative treatment (OMT)?

After an OMT session, you can usually go back to your usual activities in a day or two. You may feel a little sore for a couple of days after treatment, but you shouldn’t feel any severe pain. Talk to your provider about beginning or resuming an exercise program and other activities.

When should I see my healthcare provider about osteopathic manipulative treatment (OMT)?

Call your provider if soreness lasts longer than a few days after treatment. Severe pain isn’t a typical side effect of osteopathic manipulative treatment.

Osteopathic manipulation vs. physical therapy vs. chiropractic adjustments — what’s the difference?

Physical therapists and chiropractors receive training in their respective fields. Only DOs and MDs are licensed to prescribe medications and provide specialized medical care.

The key differences between OMT, physical therapy and chiropractic care:

• Chiropractic adjustments often involve force to treat a specific skeletal system injury. The purpose of chiropractic is to diagnose and treat musculoskeletal disorders, aiming to improve mobility, reduce pain and enhance function through application of manual therapies.
• Physical therapists help you improve function and mobility after an injury or surgery through safe exercises and activities. 
• OMT is a hands-on manipulative approach to holistic care. It’s one part of care that DOs provide to treat the whole person.